be remiss in my responsibility as a clergyman if I did not remind you of the Episcopal vestryman's prayer, "O Lord, You keep him humble and we'll keep him poor." The people back home need financial

resources.

Mr. ROGERS. Thank you. I hope it will be encouraging to you to know this, that this is one approach we are considering now, but Mr. Kyros and I have joined in introducing legislation to do something about the LSD problem, the hallucinogens, the barbiturates, and we are trying to get initiated an effective educational program, and I think we are pushing in the right direction here, and I think this is going to come about as the result of the work of this committee.

It is going to take time, of course, but I think we are well along our pathway to really accomplishing something in constructive programs to meet those problems.

Dr. WORKS. May I add for the record here a brandnew drug pamphlet which the North Conway Institute has just published entitled, What You Need To Know About Drugs*** Stimulants, Depressants, Hallucinogens, Narcotics, Deliriants, Alcohol." I would like to add this pamphlet as part of my written statement for the record. Mr. ROGERS. The committee would like to have that for its file. (The document referred to has been placed in committee files.) Mr. ROGERS. Thank you so much.

(Whereupon, at 12:45 p.m. the committee recessed, to reconvene at 2 p.m. the same day.)

AFTER RECESS

(The committee reconvened at 2 p.m., Hon. Paul G. Rogers presiding.)

Mr. ROGERS. The subcommittee will come to order, please.

We have some witnesses who have to catch planes. We will try to get to them in order as rapidly as possible.

I believe the one who has to catch the first plane is George Dimas, who is president of the North American Association of Alcoholism Programs and executive director of alcohol studies and rehabilitation section, State mental health division, Portland, Oreg.

Mr. Dimas, it is a pleasure to have you, and we are delighted to hear from you now. If you want, we will make your statement a part of the record, without objection, following your remarks. If you could give us your comments, this would be helpful.

STATEMENT OF GEORGE C. DIMAS, PRESIDENT, NORTH AMERICAN ASSOCIATION OF ALCOHOLISM PROGRAMS; ACCOMPANIED BY GUS HEWLETT, EXECUTIVE SECRETARY; AND BERNARD LARSEN, FORMER MEMBER, BOARD OF DIRECTORS

Mr. DIMAS. Because of the limited time, we are going to suggest again that we would like to submit our entire testimony for the record, and attempt in a short period of time to give you a condensed form of our presentation.

We want to thank you for the chance to appear before you today. I have with me Gus Hewlett, to my right, who is executive secretary, and at this time I would like to extend to you and your committee

and your colleagues the services of Mr. Hewlett, who has his offices in Washington, D.C.

Mr. ROGERS. Yes; we know Mr. Hewlett, and the good work he does, and we appreciate that offer.

Mr. DIMAS. I have Mr. Bernard Larsen from North Dakota, a former State legislator from that State, and a former member of our board of directors, and a person well informed on the legislative effort.

Mr. ROGERS. It is a pleasure to see you today.

Mr. DIMAS. Our association is comprised of 42 or 43 governmental programs. The governmental programs are parts of other governmental health bodies such as mental health division, such as health departments, such as public welfare departments. I emphasize this point to you, because the alcoholism programs do have a wealth of strength to gather from, rather than working autonomously, as some people might imply at times.

We have an additional 72 agencies which are governmental programs involved in treatment and rehabilitation programs related to alcohol problems.

The association also is considered the professional organization in the field. By this I mean professional people do belong to this association.

The North American Association of Alcoholism Programs strongly supports the provisions of title III, part A of H.R. 15758. We commend Chairman Staggers for introducing this progressive legislation. We also commend this committee for taking early action on this significant legislation.

In prior testimony reference has been made to the President's Crime Commission reports. Many recommendations in these reports are embodied in the provisions of title III, part A of the bill.

I would like to make reference to a February 29 report of a special committee of leading traffic safety experts to the Secretary of Health, Education, and Welfare who recommended a massive Federal program to eradicate the disease of alcoholism.

Reference has also been made in prior testimony to the two district court decisions that held that a chronic offender could not be convicted for the offense of public intoxication. Reference has been made to the pending Supreme Court decision in the Powell v. Texas

case.

You gentlemen are aware of the amicus briefs that have been prepared. There was a broad spectrum of interested groups supporting this brief, which included the American Medical Association, the North American Judges Association, and other similar organization. These court decisions certainly represent a humane, logical advance from the outmoded custom of punishing sick people.

We applaud these decisions, but we recognize they present major problems to localities. I believe communities are ready to accept the decisions, but they are not ready to develop health services rather than criminal services for these clientele.

We feel strongly that the Federal Government can not and must not assume the total responsibility for providing the necessary facilities and other resources to meet this pressing need. We believe that the

States and communities have an essential responsibility in this area. However, the Federal Government does have a clear duty to help other governmental jurisdictions to meet the needs of our society.

Enactment, implementation and funding of title III, part A of H.R. 15758 will be a significant step by the Federal Government in fulfilling that duty.

Passage of this act will provide much needed impetus for the States to expand their own existing alcoholism care and control programs and to the establishment of new facilities and resources to meet the impending need. This will be in the beginning.

At this point I would like to make three suggestions concerning the provisions of H.R. 15758. One relates to emergency care. It is felt by the association that emergency facilities should be specifically designated as one of the types of facilities eligible for Federal assistance in the construction, staffing, maintenance, and operation provisions of title III, part A, of H.R. 15758, with a specific provision authorizing emergency care facilities, the possibility of adequate care for intoxicated alcoholics will be substantially reduced.

Two, existing health, welfare, and rehabilitation legislation. Comprehensive Federal assistance to States and communities can also be generated through the whole spectrum of Federal health and welfare programs. Congress has passed much solid legislation relative to the activity of various Federal agencies under which alcoholism help is available.

Alcohol agencies are receiving almost no consideration by these agencies, and they have a low priority in others.

Evidence of this is seen by the fact that a total of only $11.2 million was spent by the Depatrment of Health, Education, and Welfare during the current fiscal year despite the fact that the former HEW Secretary has called alcoholism the most neglected health problem facing the Nation today.

For the same fiscal year, the amount appropriated to the National Cancer Institute was $183,356,000. Added to this figure were millions of dollars appropriated to the cancer control branch, the Veterans' Administration and the Atomic Energy Commission.

There are approximately 1 million people under treatment for cancer. Alcoholism, with approximately 5 million victims, is currently receiving less than 5 percent of the Federal attention which cancer receives.

Similar statistics can be given to heart disease, vocational rehabilitation, and mental retardation. These are all worthwhile endeavors, but alcoholism should be accorded far greater recognition than it is currently receiving.

We would therefore strongly urge the Congress to reassert its intent that existent social, health, welfare, and rehabilitation acts must and should be utilized to aid in programs of alcoholism control, and control where applicable, care and control.

The third recommendation is regarding training programs. Training professional personnel to staff alcoholism treatment facilities is a crucial need in the field. A very limited number of professionally qualified personnel are devoting time and energy to the problems of alcoholism. This, coupled with the new acute problems posed by the court decisions makes necessary a large number of workers in the field.

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The above points, emergency care, existing health, welfare and rehabilitation legislation and training, we respectfully submit, could be in a preamble to title III, part A, of H.R. 15758.

On pages 6 and 7 of my formal testimony a recommended preamble is included. The inclusion of such a preamble would, in our judgment, greatly strengthen the bill without affecting the amount of funds necessary to be appropriated by Congress. We respectfully urge your consideration to include such a preamble.

The last two comments, significant existing Federal efforts: Two significant developments have taken place as a result of the President's Health Message to Congress on March 1, 1966.

One of these was the establishment of the National Advisory Commission on Alcoholism, the purpose of which is to advise the Secretary of Health, Education, and Welfare on appropriate alcoholism related activity of the Department.

The second was the establishment of the National Center for the Prevention and Control of Alcoholism within the National Institute of Mental Health. Both of these actions were administratively implemented. Our association believes that these important governmental activities should be made statutory by Congress and that the amount of the appropriations and the size of the staff of the National Center should be increased to a level permitting the degree of services and research commensurate with the magnitude of the problem.

Although the court decisions have pointed up the need to handle the large numbers of patients found to be alcoholics, it must be pointed out that the chronic alcoholic coming to the attention of the court makes up a small part of the alcoholic population. Enactment of this legislation will be of great help in the efforts to control the disease. This will stimulate professional people to become involved, and awareness of all sectors of society will insure that progress will be made on this most complex problem.

(Mr. Dimas' prepared statement follows:)

STATEMENT OF GEORGE C. DIMAS, PRESIDENT, NORTH AMERICAN ASSOCIATION OF ALCOHOLISM PROGRAMS

The North American Association of Alcoholism Programs strongly supports the provisions of Title III, Part A of HR-15758 to be known as the "Alcoholic Rehabilitation Act of 1968." We commend Chairman Staggers for introducing this progressive legislation so urgently needed to cope with what is now recognized to be a major medical-social problem by medical authorities, social scientists, members of the Bar and Bench and law enforcement authorities.

We also commend this committee for taking early action on this significant legislation. Alcoholism is a major problem-there being between 5 and 6 million Americans who have the disease. This illness knows no socio-economic or ethnic boundaries. It is a problem recognized by Congress to be in need of early federal action. That this recognition and interest is non-partisan is seen by the fact that of the 95 members of the 90th Congress who have sponsored alcoholism legislation both political parties are heavily represented. In two messages to Congress the President gave substantial attention to the needs in this field of interest. Further, the 1964 Republican Platform contained a significant statement concerning the need for the federal government to become actively engaged in combating alcoholism. This is a problem above partisan consideration and the Administration as well as Congress has clearly demonstrated this fact, which is deeply appreciated by those in the field.

The President's Commission on Law Enforcement and Administration of Justice and his Commission on Crime in the District of Columbia both found arrests for public drunkenness to be an unnecessary and unwarranted waste of

law enforcement resources. One of every three non-traffic-related arrests for the nation in 1965 was found to be for public intoxication. The arrests for this offense in several urban areas numbered up to one-half of all non-traffic arrests. Specific and similar recommendations were made independently by both Commissions concerning this problem. Many of these recommendations are embodied in the provisions of Title III, Part A of HR-15758.

A February 29 report of a special committee of leading traffic safety experts to the Secretary of Health, Education and Welfare recommended. "A massive federal program to eradicate 'the disease of alcoholism' . . ." In 1961 the National Institute of Mental Health supported a 5-year comprehensive study in depth of the problems of alcohol in American society. The recently published report of this Commission reflects the vital need to make sweeping changes in the techniques of dealing with these problems. The provisions of Title III, Part A, of HR-15758 meet several of these needs at the federal level.

The January 22, 1966 ruling of the Fourth U.S. Circuit Court of Appeals in the case of Driver v. Hinnant declared it violative of the 8th amendment of the U.S. Constitution to hold alcoholics criminally liable for public intoxication. Such long-established practice, held the Court, constitutes "cruel and unusual punishment." The decision of Easter v. District of Columbia, similarly precluded convicting an alcoholic for his public intoxication. Municipal courts in Philadelphia and Atlanta have since made similar rulings. Thus, in five states an several municipalities it is now against the law to punish chronic alcoholics for public drunkenness charges. This ruling is likely to be extended across the land within the next two months when the U.S. Supreme Court is expected to render a decision in the case of Powel v. Texas, a case similar to the Driver and Easter cases. The high court heard oral arguments in the Powell case on March 7, 1968.

Amici Curiae representing a wide spectrum of interests have urged the Supreme Court to hold in the Powell case that a chronic alcoholic may not be punished for his public intoxication. In addition to NAAAP, Amici Curiae that took this position were: American Civil Liberties Union, American Medical Association, Correctional Association of New York, Methodist Board of Christian Social Concerns, North American Judges Association, North Conway Institute, Texas Commission on Alcoholism, Washington D.C. Area Council on Alcoholism. In their amicus brief, these organizations supported the recommendations of the President's Crime Commissions that public drunkenness statutes should be repealed and replaced with humane and effective public health measures. Thus, these organizations support legislation of the scope and thrust being considered here today. Another organization, the National Council on Alcoholism, filed a separate brief in support of Mr. Powell and that organization also supports Title III, Part A, of HR-15758.

These court decisions represents a humane, logical and progressive departure from the outmoded and primitive custom of punishing sick people for displaying symptoms of their illness. While NAAAP applauds these decisions, we recognize that they present major problems for state and community health, welfare and alcoholism treatment facilities which must transfer responsibility for the chronic homeless alcoholic from the criminal system to a public health, welfare and rehabilitation system.

The implications of the expected Supreme Court decision can best be seen from a description of what took place in Washington, D.C. following the Easter decision. The nation's Capital was, as is the entire country today, totally unprepared to handle the many patients found by the courts to be chronic alcoholics, In the first six months following the Easter decision, more than 2,000 chronic alcoholics were referred by the court to the D.C. Health Department. The number today is in excess of 5,000. Chaos resulted because of the completely inadequate resources available in Washington to treat alcoholics. It has now been two years since the Easter decision, during which time a 425-bed inpatient diagnostic and tratment unit has been established, along with a 50-bed detoxification unit (an emergency care facility where patients suffering acute intoxication are cared for on a temporary basis). Further, a Community Mental Health Treatment Center has been established with a 50-bed unit for alcoholics. A halfway house for alcoholics has recently been established. The D.C. General Hospital and St. Elizabeths Hospital both have had to expand their services for the treatment of alcoholism. Still, the District Health Department's outpatient treatment center for alcoholics,